| NPI | 1962199331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAHUL PATEL Owner 352-239-2177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2023-04-18 |
| Last Update Date | 2023-05-03 |